Healthcare Provider Details

I. General information

NPI: 1073427902
Provider Name (Legal Business Name): ANDOVER HEALTH AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 ANDOVER ST
ANDOVER MA
01810-5606
US

IV. Provider business mailing address

80 ANDOVER ST
ANDOVER MA
01810-5606
US

V. Phone/Fax

Practice location:
  • Phone: 978-470-3434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAY SCHEINER
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 845-293-2098